The area is dominated by mountain ranges and the upper reaches of the Clutha River and tributaries. The wide flat plateau of the Maniototo which lies between the upper reaches of the Taieri River and the Clutha's northern tributary the Manuherikia is also usually considered part of Central Otago.

Since the 19th century, most of the area's economic activity has centred on sheep, stone fruit, and tourism. In recent years, deer farms and vineyards have increased the region's economic diversification. Recently the cool climate varieties Riesling and Pinot noir have been recognised as being especially suitable, and as the vines age Central Otago wines can be expected to improve even further, as the plantings are new and increasing rapidly. Central Otago is the world's southernmost commercial wine production region.

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The Central Otago District Council, based in Alexandra, and the Queenstown Lakes District Council, based in Queenstown, administer territorial authority matters, while the Otago Regional Council has overview of environmental matters such as clean air and water resources.

Central Otago is a land of extremes: it is the coldest, driest part of New Zealand. The seasons are sharply defined: summers are hot and low in humidity; winter mornings are often misty, the days cloudless and windless and the nights freezing. Alexandra, for example, has the lowest average annual rainfall (340mm) recorded anywhere in New Zealand, is the least windy and has 148 frosts annually (only Lake Tekapo, with 149, has more). Ophir, 27 km away, holds the record for the lowest air temperature recorded - minus 21.6 deg C in mid-1995 - but it also held the highest reading (35.2 deg C in 1959) until 42.4 deg C was recorded at Rangiora, in Canterbury in 1973.

T. Gilchrist & Sons - boasts being the oldest existing shop in New Zealand, established 1902, and since 1987 operated by a community trust (but still working as a normal grocery).

The colloquial name for Central Otago is simply "Central". Residents from the surrounding regions may not talk about being in Central Otago or going to Central Otago - instead referring to being or going "up Central" (this usage is mainly limited to residents of Canterbury, Otago and Southland). The former Otago Central Railway, which ran through most of the major towns of Central Otago, was also referred to as 'the Central'.